The health gap: New mortality rates show how the north loses out to the south

New mortality data highlights serious divisions across England but is intended to help councils improve public health

If you are lucky enough to live in the borough of Wokingham, you can breathe a little easier today – your chances of living to a ripe old age are better than in any other part of the country. However, if you are reading this at home in the city of Manchester – the new is not so good.

For the first time Public Health England (PHE) has mapped mortality rates across the country so that local people and councils can see where they rank for premature deaths from the four main killers: cancer, lung disease, liver disease, and heart disease and stroke.

The figures, which are available on a new website, Longer Lives, reveals “shocking” disparities between mortality rates in richer and poorer parts of the country, with a wide north-south divide.

The health secretary Jeremy Hunt said that the regional variation “cannot continue unchecked” and called on councils to work harder on public health.

However, the publication of an early death “league table” has already alarmed local authorities who say it “dangerously oversimplifies” complex health problems.

The figures show that people living in the worst performing area, Manchester, are more than twice as likely as people in Wokingham, in the south of England, to die before the age of 75. On average, for every 100,000 people who live in the south, 258 will die prematurely, compared to 308 in the north.

Local councils recently took over responsibility for public health, including initiatives to cut smoking and drinking and lower obesity rates, from the NHS. They are now under pressure to improve in order to achieve Government targets of saving 30,000 lives a year by 2020.

“This shocking variation in early and unnecessary deaths means more people’s lives are needlessly cut short, and that cannot continue unchecked,” Mr Hunt said. “I want areas to use the data released today to identify local public health challenges like smoking, drinking and obesity.”

Local authorities have been given a ring-fenced public health budget of £5.46bn over the next two years. Overall, 103,000 deaths in England every year are considered preventable and one in three occurs under the age of 75. At present, England lags behind the rest of Europe for early deaths, ranking seventh out of 17 countries and 15 for women. 

While the worst-performing areas were almost all among the most deprived in the country, some areas bucked the trend. Rotherham achieved lower mortality rates than more affluent areas such as Bristol, Brighton and Hove and Slough.

Dr John Radford, the town’s director of public health, said that the council had targeted public health interventions at Rotherham’s 11 most deprived areas. Problems associated with obesity, such as heart disease and stroke, were being  tackled by a council-funded fat-fighting programme, which includes free exercise classes and diet advice from a local leisure centre for overweight people, he said.

“Very few areas in the country offer a comprehensive obesity service,” Dr Radford said. “It’s all about working with communities, and getting people into existing services.”

Professor John Newton, chief knowledge officer at PHE, said that making regional health data available to the public would help councils share successful ideas.

“There are inequalities and England is not doing as well as it could,” he said. “Longer Lives is an initiative presenting a clear picture of health in local areas – where it is good and bad – so everyone involved can consider and agree how to make improvements from a common basis of knowledge.”

However, the Local Government Association (LGA) warned that figures from the Longer Lives league table and map should be taken “with caution”.

“The reality is that in many cases it could take years before we see reductions in the number of those suffering with conditions like cancer or heart disease as a result of new public health initiatives,” said Cllr Zoe Patrick, chair of the LGA’s Community Wellbeing Board. “Using [this data] out of context to create any sort of national league table dangerously oversimplifies matters and ignores the very complex socio-economic and cultural factors that affect the premature mortality rate.”

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